Impact of In-Hospital PCSK9 Inhibition on Myocardial Inflammation After Myocardial Infarction: A Randomized Clinical Trial

ARTICLE: Impact of In-Hospital PCSK9 Inhibition on Myocardial Inflammation After Myocardial Infarction: A Randomized Clinical Trial

AUTHORS: Efthymios Ziogos, Tarek Harb, Ines Valenta, Michael A Vavuranakis, Palmer L Foran, Marlene S Williams, Michael J Blaha, Allison G Hays, Steven R Jones, Thomas H Schindler, Steven P Schulman, Gary Gerstenblith, Thorsten M Leucker

JOURNAL: JACC Basic Transl Sci. 2025 May 5:S2452-302X(25)00162-7. doi: 10.1016/j.jacbts.2025.03.010. Online ahead of print.

Abstract

In a randomized trial with 55 participants from the Evolocumab in Acute Coronary Syndrome trials, patients with non-ST-segment elevation myocardial infarction (MI) or ST-segment elevation MI received a single dose of evolocumab or placebo, with myocardial inflammation assessed via ¹⁸F-fluorodeoxyglucose positron emission tomography scans at baseline and at 30 days. Evolocumab significantly reduced inflammation (SUV_mean) compared with placebo. PCSK9 levels at 30 days correlated with SUV_mean, and higher SUV_mean was linked to increased end-systolic volume at 6 months. These findings suggest that early PCSK9 inhibition reduces post-MI myocardial inflammation and may influence cardiac remodeling in the months following the acute event.

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